Testing and Treatment
TESTING FOR VASCULAR DISEASE
Ankle-brachial Index: Patients with leg artery blockage are at increased risk of heart attack and stroke. This test (ABI) is a simple, safe, painless test for blockages. A blood pressure cuff is placed above the ankles and pressures are measured compared to arm pressures to determine the risk of cardiovascular events. It takes 5–10 minutes.
Carotid Duplex Scan: Blockage in a major artery increases the likelihood of a stroke. Thickening of the walls of the carotid arteries can lead to heart attack. An arterial duplex scan is a safe, painless, highly accurate method of determining blockage. A sound wave device, placed lightly on the skin, can tell if there is a problem. It takes 15–20 minutes.
Abdominal Aortic Ultrasound: Abdominal aortic aneurysm (AAA), a weakening, bulging or ballooning of the major artery in the abdomen, is the ninth most common cause of death in the U.S. Patients may not know they have an AAA, and often the first symptom is rupture. Ultrasound is a safe, reliable method of determining the presence of an AAA. The ultrasound device is placed lightly over the skin of the abdomen and measurements are made. It takes 20–25 minutes, and requires fasting.
Cholesterol-lowering medications. Patients may take a cholesterol-lowering drug called a statin to reduce the risk factor for heart attack and stroke. High blood pressure medications. Persons with high blood pressure may be prescribed medications such as beta blockers or ACE inhibitors.
Medication to control blood sugar. It becomes even more important to control blood sugar (glucose) levels in diabetics.
Medications to prevent blood clots. Because peripheral artery disease is related to reduced blood flow to the limbs, it’s important to reduce the risk of blood clots. A doctor may prescribe daily aspirin therapy or another medication that helps prevent blood clots.
Symptom-relief medications. Some drugs increase blood flow to the limbs by preventing blood clots and widening the blood vessels.
Angioplasty, atherectomy, stenting and surgery. In some cases, angioplasty or surgery may be necessary to treat blood flow problems caused by peripheral artery disease.
Angioplasty. In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on its tip is inflated to reopen the artery and flatten the blockage
into the artery wall, while at the same time stretching the artery open to increase blood flow. The doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.
Atherectomy. A specialized catheter is inserted inside of a blood vessel and removes plaque buildup, learing the way for increased blood supply.
Lasers. The doctor uses small devices or lasers to remove plaque from the sides of the blood vessels.
Thrombolytic (Clot busting) therapy. If there is a blood clot blocking an artery, the doctor may inject a clot-dissolving drug into the artery at the point of the clot to break it up.
Endovascular Abdominal Aortic Aneurysm Repair (EVAR). This is a minimally invasive procedure to repair enlarged arteries in the abdomen.
Thoracic Endovascular Aneurysm Repair (TEVAR). This is a minimally invasive procedure to repair enlarged arteries in the chest or thorax.
Bypass surgery. The doctor may create a graft bypass, using a vessel from another part of the body or a blood vessel made of synthetic fabric. This technique allows blood to flow around—or bypass—the blocked or narrowed artery.